Essay: Keeping our aging communities moving

Holly Tuokko is the director of the University of Victoria's Centre on Aging.

Photograph by: Submitted photo
, Province files

Community mobility plays a central role in the daily lives of all Canadians. Even after retirement, when work demands are reduced, being able to engage and play an active role in the community remains of high importance for the physical and mental health of older adults. Driving continues to be the most common form of transportation used by older Canadians and many have come to rely on their private vehicle as their only means of transport.

Older adults are the fastest growing segment of the population and, according to Statistics Canada, the number of older adults is projected to increase from 4.3 million to 8.0 million between 2006 and 2026. At the same time, the number of older adults holding drivers’ licenses is rapidly increasing both in relative and absolute terms. With this shift in the makeup of the licensed driving population comes the realization that older drivers may be at increased risk for driving-related injury. There is evidence of elevated crash rates, particularly for very old drivers, those over age 80, and that older drivers are more likely to die, sustain injury or be admitted to hospital following a crash.

There are a number of reasons why older adults may be at increased risk when driving. Most people experience some changes to sensory, physical and cognitive abilities as part of the physical maturation process or in relation to age-related diseases. Many medical conditions or treatments for them can have an effect on driving. Driving is a complex task requiring the integration of many different abilities and so may be affected by a variety of different changes in a person’s functioning. In addition, over an older adult’s driving career, changes may have also taken place in the driving environment in terms of the “rules of the road,” road design, or traffic density. Once an initial driver’s licence is issued, it is standard practice for there to be no review until a concern is identified. Lack of familiarity with the new roadway procedures or changes in driving practice may increase the chances of sustaining injury.

In response to these changes, many older adults choose to regulate their driving (e.g., no longer drive at night) or stop driving altogether of their own accord. Self-regulation of driving allows a person to avoid risk and maximize their driving performance so they can stay independently mobile for as long as possible. Others choose not to continue to drive and find ways to make lifestyle changes so they can continue to engage and play an active role in their community (e.g., moving to a central area).

The decisions involved in making these changes can be challenging. In communities, a focus on driving practices that prevent injury and promote health, well-being and public safety for all drivers, will help identify information needed to make informed decisions. An awareness of issues related to safe driving, including the impact that health conditions have on driving and provincial licensing requirements, is imperative when making an informed decision. Driving refresher programs, both in a classroom and on-road, can be very informative and are easily accessible in many regions. Opportunities for self-evaluation of driving-related skills may also be of benefit for some.

A broader focus by communities on mobility options that reduce the necessity for driving and are age-friendly may also yield information needed to make informed decisions. Some communities employ age-friendly public transit such as buses that kneel; mini-buses that stop closer to home; or vans that accommodate wheelchair access and companion travel. In addition, private businesses providing transportation options are taking older riders into consideration by providing taxis that are wheelchair accessible, services that provide a driver who accompanies and assists an older adult, or specific-purpose options for groups to travel to events. Volunteer drivers are available in many communities and delivery services for meals, groceries or medications are becoming more common.

As yet, it is only the larger, urban areas that host a wide range of community mobility options. Small communities, and specifically those that are rural and/or remote, may have limited resources for service development. Even where options are available in a community, each option has its limitations and travel between communities typically remains a challenge. It is unlikely that any single option will be as convenient as the privately owned vehicle for getting people where they want to go when they want to go there. However, the need to find accessible, affordable community mobility options that prevent injury and promote health, well-being and public safety must keep pace with the Canadian population as it ages.

Dr. Holly Tuokko is the Director of the Centre on Aging at the University of Victoria (www.coag.uvic.ca). From, 2002-2007, she held a Senior Investigator Award from the Institute of Aging of the Canadian Institutes of Health Research to conduct research about older adults, mental health and functional capacities, including driving. She began her research on older drivers at the University of B.C. Clinic for Alzheimer Disease and Related Disorders in 1988, served on the National Advisory Committee for the Blueprint for Injury Prevention in Older Drivers (www.caot.ca) in 2007-2008 and has led interdisciplinary teams of researchers working on older driver safety. She is the Victoria site investigator for the Canadian Driving Research Initiative for Vehicular Safety in the Elderly (www.candrive.ca), a study following older drivers for five years in seven Canadian cities.

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